Validation of the German Life-Space Assessment (LSA-D): cross-sectional validation study in urban and rural community-dwelling older adults

Objectives To develop a German version of the original University of Alabama at Birmingham Study of Aging Life-Space Assessment (LSA-D) for measurement of community mobility in older adults within the past 4 weeks and to evaluate its construct validity for urban and rural populations of older adults...

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Main Authors: Paul Gellert, Sandra Angelika Mümken, Malte Stollwerck, Julie Lorraine O'Sullivan, Joern Kiselev
Format: Article
Language:English
Published: BMJ Publishing Group 2021-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/7/e049926.full
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author Paul Gellert
Sandra Angelika Mümken
Malte Stollwerck
Julie Lorraine O'Sullivan
Joern Kiselev
author_facet Paul Gellert
Sandra Angelika Mümken
Malte Stollwerck
Julie Lorraine O'Sullivan
Joern Kiselev
author_sort Paul Gellert
collection DOAJ
description Objectives To develop a German version of the original University of Alabama at Birmingham Study of Aging Life-Space Assessment (LSA-D) for measurement of community mobility in older adults within the past 4 weeks and to evaluate its construct validity for urban and rural populations of older adults.Design Cross-sectional validation study.Setting Two study centres in urban and rural German outpatient hospital settings.Participants In total, N=83 community-dwelling older adults were recruited (n=40 from urban and n=43 from rural areas; mean age was 78.5 years (SD=5.4); 49.4% men).Primary and secondary outcome measures The final version of the translated LSA-D was related to limitations in activities and instrumental activities of daily living (ADL/iADL) as primary outcome measure (primary hypothesis); and with sociodemographic factors, functional mobility, self-rated health, balance confidence and history of falls as secondary outcome measures to obtain construct validity. Further descriptive measurements of health included hand grip strength, screening of cognitive function, comorbidities and use of transportation. To assess construct validity, correlations between LSA-D and the primary and secondary outcome measures were examined for the total sample, and urban and rural subsamples using bivariate regression and multiple adjusted regression models. Descriptive analyses of LSA-D included different scoring methods for each region. All parameters were estimated using non-parametric bootstrapping procedure.Results In the multiple adjusted model for the total sample, number of ADL/iADL limitations (β=−0.26; 95% CI=−0.42 to −0.08), Timed Up and Go Test (β=−0.37; 95% CI=−0.68 to −0.14), shared living arrangements (β=0.22; 95% CI=0.01 to 0.44) and history of falls in the past 6 months (β=−0.22; 95% CI=−0.41 to −0.05) showed significant associations with the LSA-D composite score, while living in urban area (β=−0.19; 95% CI=−0.42 to 0.03) and male gender (β=0.15; 95% CI=−0.04 to 0.35) were not significant.Conclusion The LSA-D is a valid tool for measuring life-space mobility in German community-dwelling older adults within the past 4 weeks in ambulant urban and rural settings.Trial registration number DRKS00019023.
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spelling doaj-art-3d2e58c75af04b079a8eb7e8f0cb82652025-08-20T02:18:47ZengBMJ Publishing GroupBMJ Open2044-60552021-07-0111710.1136/bmjopen-2021-049926Validation of the German Life-Space Assessment (LSA-D): cross-sectional validation study in urban and rural community-dwelling older adultsPaul Gellert0Sandra Angelika Mümken1Malte Stollwerck2Julie Lorraine O'Sullivan3Joern Kiselev4Institute of Medical Sociology and Rehabilitation Science, Charité University Medicine Berlin, Berlin, GermanyInstitute of Medical Sociology and Rehabilitation Science, Charité University Medicine Berlin, Berlin, GermanyInstitute of Medical Sociology and Rehabilitation Science, Charité University Medicine Berlin, Berlin, GermanyInstitute of Medical Sociology and Rehabilitation Science, Charité University Medicine Berlin, Berlin, GermanyDepartment of Anesthesiology and Operative Intensive Care Medicine, Charité University Medicine Berlin, Berlin, GermanyObjectives To develop a German version of the original University of Alabama at Birmingham Study of Aging Life-Space Assessment (LSA-D) for measurement of community mobility in older adults within the past 4 weeks and to evaluate its construct validity for urban and rural populations of older adults.Design Cross-sectional validation study.Setting Two study centres in urban and rural German outpatient hospital settings.Participants In total, N=83 community-dwelling older adults were recruited (n=40 from urban and n=43 from rural areas; mean age was 78.5 years (SD=5.4); 49.4% men).Primary and secondary outcome measures The final version of the translated LSA-D was related to limitations in activities and instrumental activities of daily living (ADL/iADL) as primary outcome measure (primary hypothesis); and with sociodemographic factors, functional mobility, self-rated health, balance confidence and history of falls as secondary outcome measures to obtain construct validity. Further descriptive measurements of health included hand grip strength, screening of cognitive function, comorbidities and use of transportation. To assess construct validity, correlations between LSA-D and the primary and secondary outcome measures were examined for the total sample, and urban and rural subsamples using bivariate regression and multiple adjusted regression models. Descriptive analyses of LSA-D included different scoring methods for each region. All parameters were estimated using non-parametric bootstrapping procedure.Results In the multiple adjusted model for the total sample, number of ADL/iADL limitations (β=−0.26; 95% CI=−0.42 to −0.08), Timed Up and Go Test (β=−0.37; 95% CI=−0.68 to −0.14), shared living arrangements (β=0.22; 95% CI=0.01 to 0.44) and history of falls in the past 6 months (β=−0.22; 95% CI=−0.41 to −0.05) showed significant associations with the LSA-D composite score, while living in urban area (β=−0.19; 95% CI=−0.42 to 0.03) and male gender (β=0.15; 95% CI=−0.04 to 0.35) were not significant.Conclusion The LSA-D is a valid tool for measuring life-space mobility in German community-dwelling older adults within the past 4 weeks in ambulant urban and rural settings.Trial registration number DRKS00019023.https://bmjopen.bmj.com/content/11/7/e049926.full
spellingShingle Paul Gellert
Sandra Angelika Mümken
Malte Stollwerck
Julie Lorraine O'Sullivan
Joern Kiselev
Validation of the German Life-Space Assessment (LSA-D): cross-sectional validation study in urban and rural community-dwelling older adults
BMJ Open
title Validation of the German Life-Space Assessment (LSA-D): cross-sectional validation study in urban and rural community-dwelling older adults
title_full Validation of the German Life-Space Assessment (LSA-D): cross-sectional validation study in urban and rural community-dwelling older adults
title_fullStr Validation of the German Life-Space Assessment (LSA-D): cross-sectional validation study in urban and rural community-dwelling older adults
title_full_unstemmed Validation of the German Life-Space Assessment (LSA-D): cross-sectional validation study in urban and rural community-dwelling older adults
title_short Validation of the German Life-Space Assessment (LSA-D): cross-sectional validation study in urban and rural community-dwelling older adults
title_sort validation of the german life space assessment lsa d cross sectional validation study in urban and rural community dwelling older adults
url https://bmjopen.bmj.com/content/11/7/e049926.full
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